What services are available to my child with autism or Aspergers in BC schools?

I am often asked this very simple question by parents of children who come in for assessments of autism and Aspergers. And the answer is: It depends.

It depends on your specific school district, it depends on the funding the school has in total (your child's funding is often put in a big pot by the school district and divided up between several different children with special education needs...yes, it's hard to believe but in many districts this is true), and finally, it depends upon the training and availability of staff.

For the next few posts I'm going to try and walk you through this process as best I can. We will start with information about getting your child services at all. That means having him or her "designated" with a "code." And from their I will talk about what you should expect, and what you might actually get.

The process begins with a diagnosis. Depending upon your child's age he (I will be using he from now on to make this simpler to understand, although I know girls are OFTEN overlooked in this process) needs to diagnosed by an appropriately registered and trained professional. This can be done for free through several provincial services, however there is a waiting list. You start with a referral from your medical doctor. Usually the referral is to your regional autism program, and your MD should know how to do that. Start on this process early, as there is a significant wait and early treatment is important.

Children under 6 need to be assessed by a "team" including a medical doctor, speech pathologist and usually a psychologist. Children over six need only one professional, either a medical doctor or psychologist. Whoever does this needs to use two important assessment tools. These are the ADOS (Autism Diagnostic Observation System) and the ADI-R (Autism Diagnostic Interview-Revised. YThey may use additional tools, but the MUST use these, and they need to have appropriate training and experience using these. These assessment take a few hours to complete. In addition to these tools/tests the team or individual professional needs to do other investigations as well in order to rule out other possible causes of your child's behaviour of concern. This includes a cognitive test (intelligence), an academic assessment (usually the WIAT or WRAT-4) and speech/language assessments (sometimes the Test of Pragmatic Language or a similar test). Finally, you will need to complete some form of behaviour evaluation such as the ABAS. There may be other tools/tests used, but these are the basics. Depending on the age of your child and the complexity of the assessment the cost can run from $1,800 to $2,400 or higher. It usually takes three, four or five sessions to complete the assessment.

IF the assessment leads to a diagnosis of autism or Asperger's Disorder (the final diagnosis is not made by the numbers and scores but by the professional's overall judgement of your child) you will need to complete an application for funding from the Ministry of Children and Family Development if you are seeking provincial funding. You can click here and download a brochure from the ministry that takes you through all these steps. I would download this in any case.

After the assessment is complete you should get funding form completed by the professional, and he or she will attached a written report that goes with the application. You should also get a report to take to your school. Your report needs to clearly state your child's diagnosis.

The Ministry issues above are unrelated to school services and funding, they are totally separate issues and should not be confused.

Now take a copy of your report and a cover letter requesting that the school's Committee on Special Education or Support Team (different names are used in different district) evaluate your child for coding. Coding is a process where the School Based Support Team, usually, meet and determine what is going to happen about coding and what services your child will get. You should request that you be informed of ALL MEETINGS at which your child is discussed, and make sure you are asked to attend. Do this in writing even if you already know you work and can't attend these meetings. Insist on your right to be informed and attend.

I would give a copy of the report to the school based team or principal, and bring a copy to your school district's Support Services or Special Education department. Get a dated note that says they have received this, or send an email and ask for acknowledgement that it has been received. This things get lost, overlooked and forgotten, don't let that happen!

You should not be asked to attend a Support Meeting where your child is "coded," that is, given a special education designation, (for Autism the coding is G) and at that meeting an IEP or Individual Education Plan should be written. This plan looks at your child's needs and should say how they will be addressed, and how they will measure the effectiveness of their interventions (not how your child is doing!). If there are significant behaviour problems you should also request a Functional Behaviour Analysis take place by someone trained to do it and a formal Positive Behaviour Support Plan be written from that. In later posts I will go into detail about what those look like and what you should expect.

What next? Your child should be getting INDIVIDUALIZED services to help with their deficits and needs. This should include, at the least, someone supervising your child's program who has training and experience in the field of autism. The most appropriate person would be his or her teacher. The province provides training for teachers through workshops during teacher training days, and through certificate programs at POPARD, the Provincial Outreach Program for Autism and Related Disorders. Someone woking with your child should have attended these workshops - at a minimum.

When a child is "coded" for autism the school district receives money to help support that child. This is not enough money to do the job so school districts need to take those funds and combine them to create staff positions that are then shared by several children. Yes, some children with more severe behaviour problems get more staff time. You can be aware of this, monitor it, and make sure your child is getting the support they need, but also be sensitive to the fact that there is not enough funding to do what needs to be done, and districts are doing the best they can. You can make sure that funds for children with an autism coding isn't moved over to deal with children with other coding that didn't get enough funds. This does happen.

Once your child is found eligible for autism services in school you should ask to meet with the schools autism team, or with the staff member in charge of students with autism. Often there is a staff member assigned to work as a partner with the Provincial Outreach Program for Autism and Related Disorders (POPARD). This person usually has the title of "POPARD District Partner." Find this person and immediately request a consultation from the POPARD consultant. Always put your request in writing, and send a copy to the Director of Support Services or Special Services in the district.

The POPARD consultant can come to the school, review your child's case, do an observation of your child in the classroom and then meet with the staff and present a written support plan. Often they also come to the school and provide direct training to staff, as well as observation and consultation. Each school district has a specific number of hours of POPARD consultation time, it gets used fast, and there is never enough, so get on this early! If all the time that is allotted by Ministry funding is already use remember, school districts can pay for extra time, consultation and training! These are excellent professionals, highly trained with years of experience. You can find out more about POPARD by clicking here and going to their site. They have an abundance of information and videos demonstrating the services and techniques you should be seeing in your child's class.

So to review: to obtain services for your child with autism or Asperger's Disorder in British Columbia you first need to have your child diagnosed. This can be done either through a referral from your family doctor to an appropriate provincial program (such as Children's hospital) or through a private practitioner if you don't want to wait or simply want to use your own professional. The ministry website for information on this process can be found above. Next, you bring your assessment and diagnostic letter to the school and request a meeting to discuss "coding" for your child. The school should code your child, write an IEP and if necessary a behaviour plan. Finally, you should check to see that the staff working with your child are properly trained and receive appropriate supervision and consultation. Try to get your school's POPARD consultant involved.

In the next few weeks I will discuss the IEP process, writing behaviour plans, and where to go for help with curriculum. I hope this has been helpful.

For information about my private practice you may go to my website at www.relatedminds.com and look for autism services. You can also find out more about my services for children, adolescents and adults with autism or Asperger's Disorder at my PsychologyToday website or my BCAMFT/AAMFT website.

Naturopaths a good choice for Autism Treatment? Read what this SFU report says

Beyerstein BL, Downey S. Naturopathy. In: Sampson W, Vaughn L, eds. Science Meets Alternative Medicine: What the Evidence Says About Unconventional Treatments. Amherst, NY: Prometheus Books; 2000:141-163. There is suppose to be a free draft copy of this report available from SFU, but since my original reading it seems to have been taken off line. :(

But ...not to be undone, I have located some passages on Science Based Medicine where Kimball Atwood, MD blogs about this topic. In this piece, Atwood has a great quote from the book by Barry Beyerstein (the above author)and one of the fathers of the skeptics and science based medicine movement:

"In our research for this chapter, we provided naturopaths and their professional associations ample opportunity to refute the conclusions of several major commissions of inquiry over the years that deemed their therapeutic rationale lacking in scientific credibility. None of our informants was able to convince us that the field had taken these earlier critiques to heart; in fact, precious few seemed to recognize that a problem still exists. [O]ur own bibliographic searches failed to discover any properly controlled clinical trials that supported claims of the profession, except in a few limited areas where naturopaths’ advice concurs with that of orthodox medical science. Where naturopathy and biomedicine disagree, the evidence is uniformly to the detriment of the former.

We therefore conclude that clients drawn to naturopaths are either unaware of the well-established scientific deficiencies of naturopathic practice or choose willfully to disregard them on ideological grounds."

Atwood further writes that naturopaths tend to be "strongly affiliated" with the antivacciation movement and goes on to state that:

"Naturopathic beliefs — including those of “naturopathic physicians” — are rooted in vitalism, the pre-20th-century assertion that biological processes do not conform to universal physical and chemical principles. Naturopaths describe a “healing power of nature,” which is compromised by modern medicine."

Well, looking up autism on the web here in BC we see ND's (Naturopathic Doctors) who offer "chiropractic treatment" and "homeopathic vaccines" to children. What exactly is a "homeopathic vaccine" and what studies are there that show they work to prevent disease?

I. for one, eagerly await the publication of this book. I just wish the public would pay more attention to science, and less to wishful and magical thinking.

How do you find good, science based information to make your medical choices? Go to the National Academy of .....whatever field. Go to the NIH (National Institute of Health), look the topic up on Quackwatch, the science-based medicine blog or simply type the search words in to your browser adding the words "quackwatch," or "skeptic." This will usually lead you to some more critical reading. Finally, go to your medical doctor and ask.